title: Neutrophil gelatinase-associated lipocalin, a marker of tubular dysfunction, is not increased in long-term virologically controlled patients receiving a tenofovir/emtricitabine + nevirapine regimen.
abstract: OBJECTIVE
  Tenofovir may be associated with nephrotoxicity. Several studies have shown that an early increase in urinary neutrophil gelatinase-associated lipocalin (NGAL) may predict the occurrence of acute kidney injury. We investigated urine and plasma NGAL in patients on long-term treatment with nevirapine associated with either tenofovir/emtricitabine or abacavir/lamivudine.
  
  
  METHODS
  We studied 40 virologically controlled Caucasian patients on stable treatment (median >4 years) with tenofovir/emtricitabine + nevirapine (n = 20) or abacavir/lamivudine + nevirapine (n = 20), and no history of kidney disease, high blood pressure or diabetes. Plasma immunovirological parameters (NGAL and C-reactive protein) and urinary NGAL, β2-microglobulin and α1-microglobulin were measured during a routine clinical visit.
  
  
  RESULTS
  Median concentrations of NGAL were in the normal range, but were significantly higher in the abacavir/lamivudine group compared with the tenofovir/emtricitabine group both in the plasma, at 74.9 and 66.0 ng/mL (P = 0.032), respectively, and in the urine, at 36.1 and 12.8 ng/mL (P = 0.017), respectively.
  
  
  CONCLUSIONS
  Plasma and urinary NGAL concentrations remained in the normal range in this long-term virologically controlld population without any overt renal disease. The usefulness of NGAL in detecting sub-clinical renal dysfunction appears to be very limited.
authors.affiliation: Service de Maladies infectieuses et tropicales CHU Hotel Dieu, Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Allavena
authors.forename: K
authors.initials: K
authors.lastname: Bach-Ngohou
authors.forename: E
authors.initials: E
authors.lastname: Billaud
authors.forename: S
authors.initials: S
authors.lastname: Sécher
authors.forename: T
authors.initials: T
authors.lastname: Dejoie
authors.forename: V
authors.initials: V
authors.lastname: Reliquet
authors.forename: F
authors.initials: F
authors.lastname: Fakhouri
authors.forename: F
authors.initials: F
authors.lastname: Raffi
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine*; D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068679:Emtricitabine; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood* / Q000652:urine*; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000009:adverse effects / Q000627:therapeutic use*; D063065:Organophosphonates / Q000009:adverse effects / Q000627:therapeutic use*; D011518:Proto-Oncogene Proteins / Q000097:blood* / Q000652:urine*; D000068698:Tenofovir
chemical_list: D000209:Acute-Phase Proteins; D019380:Anti-HIV Agents; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D063065:Organophosphonates; D011518:Proto-Oncogene Proteins; D003841:Deoxycytidine; D019829:Nevirapine; D000068698:Tenofovir; D000068679:Emtricitabine; D000225:Adenine
keywords: HIV infection; NGAL; nucleoside analogues; renal toxicity